Assembly Bill A1938

2017-2018 Legislative Session

Enacts the "health insurance preauthorization disclosure act"

download bill text pdf

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Archive: Last Bill Status - In Assembly Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2017-A1938 (ACTIVE) - Details

Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Add §§4242 & 4905-a, Ins L; add §4905-a, Pub Health L
Versions Introduced in Other Legislative Sessions:
2009-2010: A8592
2011-2012: A199
2013-2014: A3520
2015-2016: A263, A9051
2019-2020: A1187
2021-2022: A5629
2023-2024: A842

2017-A1938 (ACTIVE) - Summary

Enacts the "health insurance preauthorization disclosure act"; requires health insurance companies to provide participating health care providers with a list of health care treatments and services that require preauthorization from the health insurance company.

2017-A1938 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1938
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 17, 2017
                                ___________
 
 Introduced by M. of A. JOYNER -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the insurance law and the public health law, in relation
   to enacting the "health insurance preauthorization disclosure act"
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section 1. Short title. This act shall be known and may  be  cited  as
 the "health insurance preauthorization disclosure act".
   § 2. The insurance law is amended by adding a new section 4242 to read
 as follows:
   §  4242.  HEALTH INSURANCE COMPANIES; PREAUTHORIZATION FOR HEALTH CARE
 SERVICES. EVERY HEALTH CARE  INSURANCE  COMPANY  SHALL  BE  REQUIRED  TO
 PROVIDE  PARTICIPATING  PHYSICIANS AND HEALTH CARE PROVIDERS, AS DEFINED
 IN SUBDIVISION SEVEN OF SECTION TWENTY-NINE HUNDRED EIGHTY OF THE PUBLIC
 HEALTH LAW, WITH AN UPDATED  LIST OF HEALTH CARE TREATMENTS AND SERVICES
 THAT REQUIRE PREAUTHORIZATION OR PRECERTIFICATION FROM SUCH HEALTH  CARE
 INSURANCE COMPANY.  SUCH LIST SHALL BE DEVELOPED BASED UPON CONSULTATION
 WITH  MEDICAL  GUIDELINES  DEVELOPED  BY  THE RELEVANT MEDICAL SPECIALTY
 ORGANIZATION AND IN CONSULTATION WITH APPROPRIATELY  TRAINED  PHYSICIANS
 PRACTICING  WITHIN  THE REGION THE HEALTH CARE INSURANCE COMPANY SERVES.
 SUCH LIST SHALL BE UPDATED ANNUALLY OR MORE FREQUENTLY  AS  APPROPRIATE.
 ONLY  THOSE  HEALTH CARE SERVICES WHICH ARE CONTAINED ON SUCH LIST SHALL
 BE SUBJECT TO PRE-AUTHORIZATION OR PRECERTIFICATION BY THE  HEALTH  CARE
 INSURANCE COMPANY. NO HEALTH CARE TREATMENT OR SERVICE SHALL BE ADDED TO
 THE  LIST  OF  SERVICES  REQUIRING PRE-AUTHORIZATION OR PRECERTIFICATION
 UNLESS THE HEALTH CARE INSURANCE COMPANY PROVIDES A  MINIMUM  OF  NINETY
 DAYS NOTICE TO PARTICIPATING PHYSICIANS AND HEALTH CARE PROVIDERS.
   §  3.  The public health law is amended by adding a new section 4905-a
 to read as follows:
   § 4905-A. PRE-AUTHORIZED SERVICES. EVERY HEALTH  CARE  PLAN  SHALL  BE
 REQUIRED TO DEVELOP AND PROVIDE TO PARTICIPATING HEALTH CARE PROVIDERS A
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

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